Accessibility View Close toolbar



By Dr. Keith E. Lewis
May 22, 2008

In 2007, nearly $20 billion was spent on cholesterol-lowering medication.  Our society has become cholesterol phobic. Elevated cholesterol is associated with a greater than normal risk of atherosclerosis and cardiovascular disease.

While antioxidants can inhibit cholesterol from oxidizing into the linings of the arteries, knowing and controlling your cholesterol levels is still an important step in preventing cardiovascular disease. Estimates are that 52% of the total population has cholesterol levels greater than 200 mg/dl and about 21% of the population has levels greater that 240 mg/dL. What is cholesterol, what are the different types of cholesterol, and how do they affect our bodies?  Low density lipoproteins (LDLs), these are the bad guys.  If you have read the newspaper, read magazines, read medical journals, and even listened to your doctor, they will tell you that LDL is the bad form of cholesterol.  LDLs carry most of the cholesterol in the blood.  However, it is the oxidized form of LDL that truly is damaging and contributes to cardiovascular disease.  Oxidized LDL is the main source of damaging, accumulation and blockage of arteries, so consequently the more LDL cholesterol you have in your blood, the greater the risk of oxidation, the greater risk of disease.  I would at this point just like to stop and take a brief look at oxidized low-density lipoprotein or oxidized LDLs. The lower the cholesterol, the lower your risk factors for heart disease.  It sounds pretty simple, but unfortunately there is a lot more to it.  Oxidized LDL is a different form of bad cholesterol and it carries a completely different set of risk factors on its own.  In your efforts to lower cholesterol, it is important not to neglect some of the steps that you can take to make LDL cholesterol lower and keep it from turning into the even more dangerous oxidized form.  Oxidized LDL cholesterol occurs when free radicals in the blood damage the existing LDL cholesterol. 

A certain amount of cholesterol, even LDL cholesterol, is needed for normal cell function.  In most people, the liver produces the right amount.  However, when there are excess of amounts of LDL either through genetics or through diet and the body does not contain enough antioxidants, there is a greater risk of LDLs becoming oxidized.  Some of the potentially serious conditions created by oxidized LDL are speeding up or enhancing the process of atherosclerosis and inhibiting nitric oxide production by blood vessels.  Nitric oxide is extremely important for its vasodilatation properties, for improved blood flow, circulation, and reduction of plaque formation.  Oxidized LDLs also impact white blood cell function by enhancing the release of chemical messengers and send those cells to an injured area.  Diabetics have been found to have a greater recurrence of oxidized LDL, but for all populations there are increased risk factors of vascular and heart disease from elevated levels.  It is the result of free radicals.  It makes ridding the body of free radicals and helps prevent LDL cholesterol from becoming oxidized.  Antioxidants are known to reduce free radicals and therefore help with oxidation or at least the prevention of oxidation.
Another type of cholesterol, high-density lipoproteins, also known as HDLs, are the good guys and again talking to your doctor, watching the news, and reading any media publication, they will talk about HDLs being the good guys.  That is the type of cholesterol we all desire to have.  HDL picks up and transports cholesterol in the blood and back to the liver which leads to its elimination from the body.  HDLs can help keep LDL cholesterol from building up in the walls of the arteries, especially the oxidized LDLs.  If your level of HDL cholesterol is below 35 mg/dL, you are at high risk for cardiovascular disease and coronary heart disease, so the higher your HDL levels, the better. 

The third type of fat or lipid in our blood and in our fat cells is called triglycerides.  Triglycerides are a form of fat that are carried throughout the bloodstream.  Most of your body's fat is in the form of triglycerides stored in fat tissue. Only a small portion of your triglycerides are found in the bloodstream. High triglyceride levels alone do not cause atherosclerosis, but lipoproteins that are rich in triglycerides also contain cholesterol which causes atherosclerosis in many people with high triglycerides.  You can deduce high triglycerides may be a sign of lipoprotein problem that contributes to coronary heart disease. 

Serum blood cholesterol levels are not only affected by what we eat and as a matter of fact studies have shown that only about 20% of our blood cholesterol level can be controlled by diet.  The other 80% is influenced by genetic factors and some other variables.  Our liver actually produces cholesterol and it produces what we need.  It is not necessary to obtain cholesterol from food. 

There are several factors that affect one's blood cholesterol levels:

1)   Heredity.  Your genes control how high your LDL cholesterol is by affecting how fast LDL is made and removed from blood.
2)   While you eat saturated fat, as I said 20% of blood cholesterol levels are directly associated with food intake, especially saturated fat.  The saturated fat does increase LDL cholesterol more than anything else in your diet.  Reducing the amount of saturated fat and cholesterol you eat, may significantly reduce the amount of blood cholesterol level.
3)   Weight.  Excess weight tends to increase LDL cholesterol levels.
4)   Physical activity or exercise.  Frequent exercise can actually lower LDL cholesterol and raise HDL cholesterol levels.  The lack of exercise does the opposite.
5)   Age and sex is a factor.
6)   Alcohol intake.  Alcohol intake increases HDL cholesterol but does not lower LDL cholesterol. Cholesterol is found in meat, poultry, sea food, and dairy products.  Foods like plants, vegetables, fruits, vegetable oil, grains, cereals, nuts, and seeds do not contain cholesterol.  Egg yolks and organ meats are very high in cholesterol.  Shrimp and crayfish are somewhat high in cholesterol.  Chicken, turkey, and fish contain about the same amount of cholesterol as do lean beef, lamb, and pork.  There are several factors that affect cholesterol:
      This is why lots of times you will hear your doctors or the media tell us that consuming a glass of red wine or other alcoholic beverage a day reduces the risk of heart attack and stroke without causing other problems for most people.
7)   Stress is a factor that affects our lives in many different ways.  Stress over the long term has been shown in studies to raise blood cholesterol levels.

The most common form of traditional medical treatment for cholesterol would include the use of statin medications and use of exercise.  For our discussion, I would like to just speak briefly on several natural or nutritional type approaches towards reduction of LDLs and specifically oxidized LDLs. 

Polycosonol is a natural supplement derived from sugarcane.  The main ingredient is octacosanol.  Octacosanol is an alcohol found in the waxy film the plants have over their leaves and fruit.  The leaves and rinds of citrus fruits contain octacosanol as does wheat germ oil.  Polycosonol has been shown to normalize cholesterol as well or better than cholesterol-lowering drugs without any of the side effects such as liver dysfunction and muscle atrophy.  Studies have also shown that polycosonol lowers harmful LDL cholesterol levels and raises protective HDL cholesterol and of course HDL does help remove plaque from arterial walls.  Polycosonol also helps stop the formation of arterial lesions.  Polycosonol also inhibits the oxidation of the dangerous LDL cholesterol.  Polycosonol also inhibits the formation of clots and may work synergistically with aspirin in that respect.  It has also been shown to inhibit thromboxane, a blood vessel constricting agent that contributes to abnormal platelet aggregation which can lead to heart attack or stroke. 

Fiber is another natural alternative to reduction of LDL cholesterol. High intake of soluble fiber is a very effective way in lowering serum cholesterol. The problem a lot of patients feel that fiber produces gastrointestinal upset, so they do not ingest enough fiber a day to have any impact on reducing cholesterol levels. Psyllium and oat bran have been shown to lower plasma LDLs in different population groups. A word of caution with psyllium. If you are taking prescription drugs digitalis or nitrofurantoin, you should not take psyllium. Chitosan is another fiber composed of chitin which is a component of shells of shellfish. Chitin has an effective magically bind to fat and cholesterol in the digestive tract. Chitosan can absorb as much as 7 to 8 times its weight of fat and bile in the digestive tract.  The fat and cholesterol are then excreted through the bile, thereby improving bowel function and reducing cholesterol levels in the body. 

Niacin, vitamin B3 is another supplement that improves cholesterol profiles when given in doses well above the vitamin requirement. 

Niacin is relatively safe however, some studies have indicated that it does affect liver enzymes, so some caution should be utilized when taking niacin. Those with hepatitis should also avoid niacin. A typical dose level of niacin per day to help reduce cholesterol levels would be 1000 to 3000 mg per day. However, some patients we find have a difficult time with that dose level of niacin because of the flushing affect due to the vasodilatory nature of niacin. There are several types of niacin currently on the market that are flush-free and well tolerated by patients.

Artichoke leaf extract reduces elevated cholesterol levels and has been found to be very effective in the prevention and treatment for atherosclerosis and coronary heart disease. 

Garlic has been beneficial.  Garlic controls prevention of excess production of oxidized LDLs.  Garlic also has a benefit in protecting the endothelial lining of the arterial system against oxidative damage.  Studies have indicated that dose levels for garlic or garlic extract to be effective would be in the 6000 to 8000 mg per day range taken with meals. Since large amounts of stomach upset occurs when taking garlic for some individuals, we recommend taking it with the largest meal of the day.  To summarize the effects of garlic in the management of cardiovascular disease, we see the following:  Reduction in cholesterol prevents the abnormal blood clot formation inside blood vessels, protects against LDL cholesterol oxidation, and protects the endothelial lining of the arterial system against oxidation which further improves the release and effect of nitric oxide activity.

Curcumin which is also known as turmeric root is an ancient spice in the ginger family and over the recent years, it has been found to be an aid in the control and reduction of cholesterol.  The use of curcumin has shown significant cholesterol level drops in recent research and recent studies. Curcumin also provides an additional benefit by potentially reducing the risk of cardiovascular-related disease as it inhibits platelet aggregation and significantly decreases the level of lipid peroxidation. Observation of curcumin's mechanism of action shows it blocks the formation of thromboxane A2, a promoter of platelet aggregation thereby inhibiting blood clot formation and more specifically abnormal blood clot formation. Gugulipid is an ancient remedy though it has only recently been rediscovered by western culture.  Recent studies have indicated that serum cholesterol levels have been reduced by as much as 70% to 80% taking 25 mg three times per day.

Green tea has also been shown to lower bad LDL cholesterol and serum triglyceride.  Green tea is a very potent antioxidant that affects and inhibits the oxidation of LDLs and of course as previously stated oxidized LDLs play a major role in atherosclerosis. 

Omega 3 fish oil has also been shown to reduce high levels of triglycerides by an average of 35%.  Fish oil does not appear to reduce cholesterol to that extent but does other benefits when consumed as part of an integrated therapy program. 

Vitamin E is very important to overall health and contributes to the protection of approximately 80 different disease processes. The recommended dose of vitamin E ranges from 400 and 800 international units per day.

Selenium used in combination with vitamin D is great one-two punch when trying to protect against LDL oxidation. Typical dosage of selenium used in combination with vitamin E would be approximately 200 mcg a day. 
Soy has recently been shown to reduce the risk of coronary heart disease. 

Diseases associated with high cholesterol, especially oxidized LDLs are a number one killer of our population.  Fats also play key role in the incidents of cancer and many other degenerative diseases.  Cholesterol exists only in animal tissues; therefore one's diet is an important first stop in its control.  For some people, however, limiting fat and cholesterol intake alone is not enough to reduce serum cholesterol to safe levels because of their own livers' production of excessive cholesterol primarily genetic factors.

The use of supplements to augment dietary modification can help reduce cholesterol without the side effects of many drugs.  The effectiveness of any cholesterol reduction therapy varies considerably between individuals.  The nutrients we recommend not only have been shown to lower cholesterol, but also protect against cardiovascular disease by other mechanisms such as inhibition of cholesterol oxidizing free radicals and abnormal blood clots inside arteries which would be a thrombosis. 

Several supplements that we have used in our practice will be listed below:  These are healthy life brand products, pharmaceutical grade supplements. 

Healthy life cholesterol support provides a complementary blend of nutritional agents that help maintain normal cholesterol. It does contain Gugulipid, papain, lecithin/, niacin, vitamin E, and vitamin C. 

We will also use a supplement called healthy life niacin slow release that obviously contains niacin. Slow-release niacin over several hours helps avoid the uncomfortable flushing action of vitamin B, so that the full benefits of cholesterol metabolism can be obtained.

Healthy life cardiac support targets homocysteine, lipid, and cardiac energy metabolism. It contains folate, vitamin B, biotin, L-carnitine, portincan, and polycosonol.

We also have a cardiac therapeutic pack which is called Healthy Life Cardiac Support Pack which contains a multivitamin as well as a variety of other supplements including Omega-3. Healthy life polycosonol helps maintain normal cholesterol.  We also utilize D ribose which helps support heart and skeletal muscle energy metabolism.

Healthy Life garlic contains 400 mg of garlic. Hawthorn extract we have found helps relax coronary blood vessels enhancing blood flow to the heart which are also key factors in maintaining normal blood pressures.